Date: 29 November 2010

To mark World AIDS Day 2010, the International Federation of Red Cross and Red Crescent Societies (IFRC) have released a report highlighting the failures of governments and donors to effectively tackle HIV and injecting drug use, and the urgency with which a human-rights based, effective response is needed. A central message of the report is the importance of prioritising harm reduction over the criminalisation of drug use – because “it works and is a human-rights based approach”.

‘Out of Harm’s Way’ outlines the severity of the epidemic and the human rights violations routinely faced by people who inject drugs around the world. Amongst the report’s several recommendations are the decriminalisation of drug users, as well as access to due legal process and health services for those who use drugs both within, and outside prisons and other closed settings. It calls upon all stakeholders, but particularly governments, to respect the human rights of people who inject drugs and those at risk of, or living with HIV. Highlighting the poor investment made to date, the IFRC also calls upon governments and donors to exert all possible efforts to make comprehensive harm reduction programmes available to drug users, and in particular to commit to predictable long-term funding.

Download the full report:

http://www.ihra.net/files/2010/11/29/Harm_reduction_report-EN-LR.pdf

© 2010 International Harm Reduction Association.

(c) The Australian

November 27, 2010.

• By Stephen Lunn, Social affairs writer

An energetic case has been put for the country to regulate and tax the production of cannabis

A GLOBAL leader on innovative drugs policy in the 1980s, Australia has been stuck in a conservative rut since, at great cost to drug users and the broader community, a high-profile US drugs policy expert warns.

And in 2010, when Australia should be contemplating the regulation and taxation of cannabis and getting safe pharmaceutical heroin in the hands of addicts, it continues to prohibit drug use to demonstrably little effect, says Ethan Nadelmann, executive director of the New York-based Drug Policy Alliance.

Nadelmann says countries that boldly declare “zero tolerance” or “a war on drugs” are deluding themselves that they can prevail over the global drug trade. Illicit drugs are cheaper and more plentiful than ever, he says.

“You really led the world when it came to implementing sensible harm-reduction policies that reduced the spread of HIV among injecting drug users,” he tells Inquirer.

“You kept your rates of HIV among injecting drug users to less than 2 per cent, whereas in America we let it explode to 40 or 50 per cent. If America had implemented the harm reduction policies in the 80s and 90s that Australia did, we’d have quarter of a million people alive today as a result.”

Nadelmann says drug policy reform in Australia then became “bogged down in politics” as European countries moved away from failing prohibitionist approaches.

His clarion call is to regulate and tax cannabis production, sale and use rather than ban it with the threat of criminal sanction.

The 2007 National Drug Strategy Household survey found more than 1.5 million Australians used cannabis in the previous year, and more than 600,000 in the previous week, evidence that prohibition is not making it more difficult to source drugs.

Nadelmann says most cannabis users aren’t addicts, or even regular imbibers, but admits the drug has adverse health consequences, with links to mental illness and schizophrenia, and poor educational outcomes for young users. The social costs of illicit drug use in Australia, including crime, health outcomes, lost productivity and road accidents, was put at $6.4 billion annually by economists David Collins and Helen Lapsley in 2008. Which is why government funds would be better spent on treatment programs for those with drug problems rather than law enforcement, he says.

The most recent data published by the Australian Bureau of Criminal Intelligence shows nearly 64,000 drug consumer arrests were made in 2007-08, and estimates of annual law enforcement costs run at between $1.3bn and $2bn.

“Marijuana arrests are the majority of all drug arrests in this country,” Nadelmann says. “It still gives people criminal records. You seem to have run out of steam when it comes to new ideas about changing this around.

“Regulating and taxing cannabis is not risk free but it’s a better approach than prohibition.”

Nadelmann visited Canberra during the week and met MPs including Malcolm Turnbull, Mal Washer and Rob Oakeshott. He says there’s an “emerging coalition” of politicians who are privately or overtly open to his case.

But one not for the turning is Bronwyn Bishop, who chaired a 2007 parliamentary inquiry into the effect of illicit drug use on families. Bishop says the public “just [doesn't] want illicit drugs legalised”. “The argument of the harm-minimisation lobby is stupid,” she says. “They say the war on drugs is failing, so it should be legalised. Would we do this with other crimes that harm people?

“The Australian public [is] smart enough to know that the more drugs are available, the more available they will be to their kids.”

She questions the way harm-minimisation proponents downplay the health effects of drugs such as cannabis.

“It’s a very damaging drug and it’s a known precursor to using other drugs,” she says.

“The public wants illicit drugs to stay that way and it’s only a few who seem to be agitating for this change that doesn’t have public support.”

Perth addiction specialist George O’Neil, who is trialling a naltrexone-implant to stop heroin addiction, is similarly unimpressed with the harm-minimisation message. “It’s disgraceful propaganda. There’s not a single mother in Australia [who] will swallow the story that’s being sold,” he says. “If an 18-year-old is using cannabis, mothers don’t want him to be given easy access to cannabis so he won’t have to commit crimes to get it. They want him not to use it.”

Undeterred, Nadelmann cites with approval the approach to drug use taken in Portugal as one that would be appropriate for his home country and Australia.

In 2001 Portugal decriminalised the possession of up to a 10-day supply of all types of illicit drugs. Those found in possession are referred to a regional committee that decides whether the person needs treatment. If no treatment is required, the possessor can be sanctioned with driving restrictions, bans from entertainment areas or fines.

Nadelmann also argues the case for more heroin injecting facilities and access for addicts to safe drugs. He says there is no medical argument that can be mounted against his case for regulation over prohibition, and the only objections are political.

By Evan Wood

People on both sides of the marijuana legalization debate have strong feelings about Proposition 19, the California ballot initiative that promises to regulate, control and tax cannabis. But science and empirical research have been given short shrift in the discussion. That’s unfortunate, because the U.S. government has actually funded excellent research on the subject, and it suggests that several widely held assumptions about cannabis legalization actually may be inaccurate. When the total body of knowledge is considered, it’s hard to conclude that we should stick with the current system.

One important question is whether laws criminalizing marijuana have effectively reduced supply and use. It would appear from available data that they have not. Despite billions spent on anti-cannabis law enforcement and a 30% increase in the number of arrests in California since 2005, marijuana remains the most frequently used illegal drug. Nationally, an estimated $10 billion is spent each year enforcing marijuana laws, yet an ongoing study funded by the National Institute on Drug Abuse has concluded that over the last 30 years, the drug has remained “almost universally available to American 12th-graders,” with 80% to 90% saying the drug is “very easy” or “fairly easy” to obtain.

On the health side of the equation, scientific consensus is that while cannabis may pose some health risks, they are less serious than those posed by alcohol and tobacco. The approach taken to regulating these other harmful substances, however, hasn’t been to criminalize them but to regulate their distribution, to impose taxes on their purchase and to educate the public about their risks. These measures have been shown to be effective, as in the case of cigarette consumption, which has dropped dramatically.

On the other hand, cannabis prohibition has not achieved its stated objectives. As detailed in a report published last week by my organization, the International Centre for Science in Drug Policy, research funded by the U.S. government clearly demonstrates that even as federal funding for anti-drug efforts has increased by more than an inflation-adjusted 600% over the last several decades, marijuana’s potency has increased by 145% since 1990, and its price has declined 58%.

In this context, supporting Proposition 19 seems like a reasonable position, and recent polls have suggested that almost half of decided voters support the ballot initiative. However, there has emerged a strong assumption in the debate that, though legalization will save police time and raise tax revenue, this will come at the cost of increasing rates of cannabis use.

This notion is based on a widely cited Rand Corp. report, which used a theoretical model to conclude that rates of cannabis use will increase if cannabis is legalized. Though the authors of this report cautioned readers that there were “many limitations to our estimate’s precision and completeness” and that “uncertainties are so large that altering just a few key assumptions or parameter values can dramatically change the results,” few seem to have read past the headline that legalization is likely to increase cannabis use.

This may be the case, but it’s not a certainty. In the Netherlands, where marijuana has been sold in licensed “coffee shops” since the 1970s, about 20% of the adult population has used the drug at some time in their lives. In the United States, where it is largely illegal, 42% of the adult population has used marijuana.

Neither Rand’s theoretical model nor other commentaries have considered the potential benefits of the broad range of regulatory tools that could be utilized if the marijuana market were legal. The state could then license vendors, impose purchasing and sales restrictions and require warning labels. Although these methods have been scientifically proven effective in reducing tobacco and alcohol use internationally, it is noteworthy that successful government lobbying by the tobacco and alcohol industries has slowly eroded many of these regulatory mechanisms in the United States.

A bill has been introduced in the California Legislature to create a uniform statewide regulatory system under the California Department of Alcoholic Beverage Control if Proposition 19 passes. Such a system would allow, finally, for an evidence-based discussion of how to optimize cannabis regulatory regimes so that the benefits of regulation (including such things as tax revenue and reduced drug market violence) can be maximized while rates of cannabis use and related harms can be minimized.

Up to now, the fact that cannabis is illegal has meant that the unregulated market has been largely controlled by organized-crime groups, and the trade has sparked considerable violence, both in the United States and in Mexico. Given the widespread availability and use of cannabis despite aggressive criminal justice measures, there is no doubt that a saner system can be created if marijuana is strictly regulated rather than left in the hands of organized crime.

Evan Wood, a physician and professor of medicine at the University of British Columbia, is the founder of the International Centre for Science in Drug Policy.

Copyright © 2010, Los Angeles Times